ADVOCATES FOR YOUTH

The Facts

The Sexual and Reproductive Health of Young People in Latin America and the Caribbean

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The population, ages 10 to 24, numbered 155 million in Latin America and the Caribbean in 2000—about one-third of the total population of the region.¹ In the region, many young people are sexually experienced, and unprotected sexual intercourse places youth at risk of unintended pregnancy, unsafe abortion, and infection with sexually transmitted diseases, including HIV. Adolescent pregnancy rates remain high in Latin America, and HIV/AIDS rates are alarming among young people in the Caribbean. Nevertheless, some reproductive and sexual health programs address the needs of youth and are showing encouraging results.

Age at initiation of sexual intercourse varies widely.

• In general, the average age at first sexual intercourse is significantly lower for males than for females in Latin America and the Caribbean. One study of young people in 11 countries found that the average age of first sexual intercourse for young men ranges from 12.7 years in Jamaica to 16.0 years in Chile; for young women, it ranges from 15.6 years in Jamaica to 17.9 years in Chile.²
• In the Caribbean, almost two-thirds of adolescents have not had sexual intercourse. Of the one-third of adolescents with sexual experience, about half reported that their first sexual intercourse was forced. More than half of sexually active young men and around one-quarter of sexually active young women reported being less than 10 years old when they first had sexual intercourse.³
• A study conducted in Mexico found that 17 percent of 15-year-old men and five percent of 15-year-old women had had sexual intercourse. By age 18, half of the men and one-fifth of women reported being sexually active.⁴

Most adolescents know about contraception, but its use has not been sufficiently promoted.

• In Latin America and the Caribbean, 90 percent or more of adolescent women know about at least one contraceptive method, except in Bolivia (74 percent), Guatemala (68 percent), and Paraguay (89 percent). Nevertheless, rates of contraceptive use are low.⁵
• In Peru, among unmarried, sexually active adolescent women, 27 percent use modern methods, 42 percent use traditional methods (rhythm or withdrawal), and 29 percent are not currently using a contraceptive method.⁶ In Colombia, the percentages are 50, 30, and 19, respectively.⁷
• In El Salvador, among sexually experienced women ages 15 to 24, only 10 percent reported using contraception at first sexual intercourse.⁸

Pregnancy and abortion occur frequently among adolescents in the region.

• Rates of adolescent pregnancy have increased and decreased in Latin America and the Caribbean during the past 20 years. In Ecuador and Mexico, for example, rates have decreased between 10 and 15 percent. In the Dominican Republic, Peru, and Trinidad and Tobago, adolescents today have 25 to 37 percent less chance of experiencing pregnancy compared to youth a generation ago. Meanwhile, there has been little change or slight increases in rates in Brazil, Colombia, Guatemala, and Paraguay.⁹
• In Ecuador, 20 percent of adolescent women have had at least one pregnancy.¹⁰ In Bolivia, 14 percent of adolescent women have experienced pregnancy.¹¹ In Northeast Brazil, 17 percent of adolescents have given birth at least once.¹²
• In Latin America, between 10 and 21 percent of hospitalizations for complications arising from unsafe abortion occurred among adolescents. Among women hospitalized after abortion, one-third of adolescents suffered sepsis, compared with one-fourth of adult women.¹³ In Peru, one-third of the women hospitalized for abortion complications were between 15 and 25 years old.¹⁴
• In Chile and Argentina, more than one-third of the maternal deaths among adolescents resulted directly from unsafe abortion.¹⁴

Although risk behaviors increase youth's vulnerability to STD/HIV infection, condom use is increasing among young people.

• A study in Trinidad and Tobago found that almost one-fourth of sexually active young men and women ages 15 to 24 have had sex with more than one partner, and less than one-fifth reported consistent condom use.⁴
• In a study among sexually active youth in Peru, 50 percent young men and 70 percent of young women reported never having used a condom.⁴ A survey in a Peruvian secondary school found that 23 percent of young men had a sexually transmitted infection (STI).²
• In a study of young men in Brazil, the percentage that reported using condoms at first sexual intercourse increased from five to 50 percent between 1986 and 1999.¹⁵ Among sexually active adolescents in Mexico, 42 percent of males and 35 percent of females reported having used a condom at first sexual intercourse. These levels are similar to those in European countries.⁴

In the Caribbean, HIV/AIDS affects an increasing number of young people, especially young women.

• More than half of all reported AIDS cases in the Caribbean are the result of unprotected heterosexual intercourse. At the same time, women represent more than one-third of AIDS cases in this region.¹⁶
• In Trinidad and Tobago, the number of women between 15 and 19 infected by HIV is five times higher than among adolescent males. In Jamaica, HIV is concentrated more and more in sexually active adolescent women.⁴

Some programs for adolescents have achieved encouraging results.

• In Colombia, a project undertaken in 13 clinics by PROFAMILIA integrated youth-friendly services into clinics that primarily served adults. Visits by adolescents to acquire contraception increased by 37 percent during the first six months of the project, compared to visits before the project. Adolescents also made more visits for gynecological services and for pregnancy tests (by 61 and 64 percent, respectively).¹⁷
• In Brazil, a school sexuality education project carried out by BEMFAM was credited with achieving an increase in correct knowledge regarding the transmission of STI/HIV (14 percent) and where to receive STI treatment (10 percent) as well as an increase in reported use of condoms at last sex (five percent).¹⁸
• In Chile, evaluation of a sexuality education program found that the program promoted a more mature attitude and responsibility toward sexuality, raised the age of sexual initiation, increased contraceptive use, and diminished the number of unintended adolescent pregnancies in an intervention group when compared with a control group.¹⁹

References

1. Boyd A et al. The World's Youth 2000 Data Sheet. Washington, DC: Population Reference Bureau, 2000.
2. Lundgren R. Protocolos de Investigación para el Estudio de la Salud Sexual y Reproductiva de los Adolescentes y Jóvenes Varones en América Latina. Washington, DC: Organización Panamericana de la Salud, 2000.
3. Halcón L et al. A Portrait of Adolescent Health in the Caribbean. Washington, DC: Pan American Health Organization, 2000.
4. Pisani E et al. HIV and AIDS in the Americas: An Epidemic with Many Faces. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS (UNAIDS), 2000.
5. Blanc AK, Way AA. Sexual behavior and contraceptive knowledge and use among adolescents in developing countries. Studies in Family Planning 1998;29:106-116.
6. Reyes J, Ochoa LH. Perú: Encuesta Demográfica y de Salud Familiar 2000. Lima, Perú: Instituto Nacional de Estadística e Informática; Calverton, MD: Macro International, 2001.
7. Ojeda G et al. Salud Sexual y Reproductiva: Resultados Encuesta Nacional de Demografía y Salud, 2000. Santafé de Bogotá, Colombia: PROFAMILIA, 2000.
8. Asociación Demográfica Salvadoreña. Encuesta Nacional de Salud Familiar: FESAL-98: Informe Final. San Salvador, El Salvador: La Asociación, 2000.
9. Alan Guttmacher Institute. Into a New World: Young Women's Sexual and Reproductive Lives. New York, NY: The Institute, 1998.
10. Centro de Estudios de Población y Desarrollo Social. Encuesta Demográfica y de Salud Materna e Infantil, ENDEMAIN-99. Quito, Ecuador: El Centro, 2001.
11. Sardán MG et al. Bolivia: Encuesta Nacional de Demografía y Salud 1998. La Paz, Bolivia: Instituto Nacional de Estadística, 1998.
12. Gupta N. Sexual initiation and contraceptive use among adolescent women in Northeast Brazil. Studies in Family Planning 2000;31:228-238.
13. Singh S. Adolescent childbearing in developing countries: a global review. Studies in Family Planning. 1998;29:117-136.
14. Bernstein S. The State of World Population 2000: Lives Together, Worlds Apart: Men and Women in a Time of Change. New York, NY: United Nations Population Fund, 2000.
15. UNAIDS. Report on the Global HIV/AIDS Epidemic. Geneva: UNAIDS, 2000.
16. Marquez PV et al. HIV/AIDS in the Caribbean: Issues and Options. Washington, DC: The World Bank, 2000.
17. International Planned Parenthood Federation. Integrating Sexual and Reproductive Health Services for Youth in Colombia. [IPPF/WHR Spotlight on Youth]. New York, NY: The Federation, [1999?].
18. ____. Working in Schools: Sex Education in Brazil. [IPPF/WHR Spotlight on Youth]. New York, NY: The Federation, [1999?].
19. Luengo X, Toledo V. Cemera, Chile: Integrating Sexuality Education and Health Services for Students. [Young Adult Reproductive Health Project Highlights]. Washington, DC: FOCUS on Young Adults, [1995?].

Escrito por Cecilia Moya
abril de 2002 © Advocates for Youth

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